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General NPI Number Information
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NPI Number | 1437813987
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Entity Type | Individual
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Provider Name | JAMES GALLAGHER
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Gender | Male
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Dates
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Enumeration Date | 10/29/2021
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 913 NW GARDEN VALLEY BLVD
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City | ROSEBURG
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State | OR
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Zip | 97471-6523
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Country | US
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Telephone | 540-440-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 840 RAILROAD ST
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City | BROOKINGS
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State | OR
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Zip | 97415-9697
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Country | US
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Telephone | 541-412-1152
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 202203723NP-PP
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 25278
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License Number State | SC
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